Out of pocket payment - Samenvattingen en Aantekeningen

Test Bank for Medical-Surgical Nursing 5E Holly Stromberg Chapter 01: Caring for Medical-Surgical Patients Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs b. To define the scope of LPN/LVN practice c. To improve the quality of care provided by the LPN/LVN d. To limit the LPN/LVN employment placement ANS: B While improv...

AHIP 2025 Module 2, AHIP 2025 Module 1, AHIP 2025 Module 3, AHIP 2025 module 4, AHHIP 2025 Module 5 Practice Questions and Answers Mr. Sanchez has just turned 65 and is entitled to Part A but has not enrolled in Part B because he has coverage through an employer plan. If he wants to enroll in a Medicare Advantage plan, what will he have to do? - ANSWER-He will have to enroll in Part B. Mrs. Walters is enrolled in her state's Medicaid program in addition to Medicare. What should she be aw...

Steps used to control costs of managed care include: - Answer Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - Answer Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - Answer HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a s...

A Medicare beneficiary has walked into your office and requested that you sit down with her and discuss her options under the Medicare Advantage program. Before engaging in such a discussion, what should you do? - Answer-You must have her sign a scope of appointment form, indicating which products she wishes to discuss. You may then proceed with the discussion. Agent Harriet Walker has recently begun marketing Medicare Advantage and related products aimed at meeting the needs of senior citi...

CSPR - Certified Specialist Payment Rep (HFMA) Questions and Answers 2023 Steps used to control costs of managed care include: Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage HMO Conventional PPO and POS H...

PTCB Pharmacy Billing and Reimbursement Practice Questions and Answers Latest . The cost of the coverage of an insurance policy is known as which of the following? A. Deductible B. Co-payment C. Coinsurance D. Premium 5. Which of the following is another name for the cardholder of the insurance policy? A. Subscriber B. Dependent Pharmacy Billing and Reimbursement PTCB Practice Test Questions and Answers Latest Rated A+ C. Patient D. Third party 6. When a patient picks up a prescrip...

Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs. b. To define the scope of LPN/LVN practice. c. To improve the quality of care provided by the LPN/LVN. d. To limit the LPN/LVN employment placement. ANS: B While improving quality of care provided by the LPN/LVN may be a result of the NPA, the primary purpose of the NPA of each state defines the scope of nursing practice in that state. PTS: 1 DIF: Cognitive ...

Jerome was shopping at ABC Imports when a light fixture fell from the ceiling and hit him on the head. Jerome's injuries resulted in an extended hospital stay, so he sued ABC Imports and was awarded $400,000. Assuming ABC Imports carries a CGL with a General Aggregate of $750,000 and a per occurrence limit of $250,000, what is the maximum that ABC's insurer will pay for Jerome's injuries? - CORRECT ANSWER $250,000 Strict Liability: - CORRECT ANSWER holds a person liable for h...

1. The major provisions of the Patient Protection & Affordable Care Act of 2010 were?Answer: -Banning of preexisting condition coverage limitations -Free preventative care -Medicaid expansion 2. Which of the following statement(s) about the finance department a t large healthcare organizations is/are correct?Answer: -The CFO typically reports directly to the chief executive officer (CEO) -The CFO is usually assisted by a comptroller and treasurer -The department is headed by the chief finan...

Pharmacy Billing and Reimbursement PTCB Practice Test Questions and Answers Latest Rated A+. Which government insurance plans offers 4 different parts or areas of different coverage? A. MedicareB. Medicaid C. TRICARE D. CHAMPVA 2. DAW/DNS stand for which of the following? A. Dispense as written B. Distribute and work C. Distribution and working D. Dispense as well 3. Which of the following third party plans requires the patient to designate a primary care physician (PCP)? A. Health ...

Steps used to control costs of managed care include: - ANSWER-Bundled codes Capitation Payer and Provider to agree on reasonable payment DRG is used to classify - ANSWER-Inpatient admissions for the purpose of reimbursing hospitals for each case in a given category w/a negotiated fixed fee, regardless of the actual costs incurred Identify the various types of private health plan coverage - ANSWER-HMO Conventional PPO and POS HDHP/SO plans - high-deductible health plans with a savings...